Spine – general

image of Spine – general
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The following are some of the indications for radiography of the spine: mono-, para- and quadriplegia; thoracic and pelvic limb paresis or paraparesis; ataxia; pain referable to a spinal lesion; stiffness; suspected vertebral deformities; and sinus tracts in the lumbar region. This chapter considers general principles, standard views and special views of radiography; normal anatomy; evaluation of a spinal radiograph; contrast studies, and alternative imaging techniques.

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20.1 Correct positioning and collimation for a lateral cervical radiograph.
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20.2 Normal lateral cervical radiographs. (a) Adult small-breed dog. (b) Very immature large-breed dog, illustrating open physes.
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20.3 Lateral thoracolumbar radiograph of a small-breed dog. Note the narrowed and mineralized intervertebral disc space at T11–12 (arrowed) and faint opacification in the associated intervertebral foramen ventrally.
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20.4 Normal lateral lumbar radiographs. (a) Adult small-breed dog. Note that the transverse processes and ilial wings are not completely superimposed, indicative of some rotation. (b) Adult cat. Note the sacrocaudal vertebral subluxation.
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20.5 Correct positioning and collimation for a VD lumbar radiograph.
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20.6 Normal VD cervical radiographs. (a) Immature large-breed dog illustrating open physes. (b) Adult small-breed dog with mineralized laryngeal cartilage (arrowed). (c) Cat.
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20.7 Normal VD lumbar radiographs. (a) Small-breed dog. The soft tissue opacity superimposing on L6 and L7 is the prepuce (arrowed). (b) Adult cat. Note the sacrocaudal vertebral subluxation.
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20.8 V45°Rt-DLe view of the cervical spine of a small-breed dog, illustrating good visibility of the dens and left-sided vertebral foramina. Herniated disc material is present in the C3–4 intervertebral foramen (arrowed).
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20.9 Schematic representation of the myelographic visibility of extradural cord compression at various locations. (a) Ventral lesion. (b) Lateral lesion. (c) Ventrolateral lesion. (Reproduced from , with permission from Compendium on Continuing Education for the Practicing Veterinarian)
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20.10 Dachshund with dorsolaterally extruded herniated disc material at the T10–11 disc space. Note that significant compression is only seen on the left oblique (V45°Le-DRt) view. (a) Lateral view. (b) VD view. (c) V45°Rt-DLe view. (d) V45°Le-DRt view.
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20.11 Positioning for the RCd open-mouth view. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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20.12 Large-breed dog with extradural ventral cord compression at C6–7. (a) Neutral position. (b) Traction position. Note the wider intervertebral disc spaces and decrease in cord compression indicative of a hypertrophied annulus fibrosus.
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20.13 Schematic representation of lateral vertebral views to illustrate normal structures. (a) Cervical. (b) Thoracic. (c) Lumbar. 1 = vertebral body; 2 = epiphysis/endplates; 3 = transverse processes; 4 = cranial articular process; 5 = caudal articular process; 6 = dorsal spinous process; 7 = accessory process; 8 = pedicle; 9 = head of rib; 10 = articular facet; 11 = intervertebral disc; 12 = intervertebral foramen. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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20.14 Normal lateral cervical myelogram views. (a) Small-breed dog. (b) Large-breed dog with the neck in flexion. (c) Cat.
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20.15 Normal VD cervical myelogram views. (a) Large-breed dog, illustrating filling defect over C2 caused by the basilar artery. (b) Small-breed dog. (c) Cat.
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20.16 Normal thoracolumbar myelogram views. (a) Large-breed dog. (b) Cat.
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20.17 Lumbar myelogram with extradural spillage and venous sinus drainage to the caudal vena cava via a vertebral vein.
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20.18 Lumbar myelogram (lateral view) of a normal cat with radiolucent filling defects due to gas bubbles (arrowed).
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20.19 Lumbar myelogram with needle placement at L4–5 and not positioned deeply enough. Note the widened central canal filled with contrast medium from L1 to L4 and continuing cranially as a 1 mm-wide line.
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20.20 (a–f) Schematic classification of myelographically detectable vertebral canal pathology. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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20.21 CT images in a bone window of lumbar vertebrae. (a) Transverse image showing the prominent sagittal ridge on the floor of the vertebral canal and the hypoattenuating fat surrounding the spinal cord. (b) Volume-rendered CT image of three lumbar vertebrae with software removal of the lamina. Note the central ridge on the dorsal aspect of the vertebral bodies. (c) Transverse image showing normal central vertebral body cleft.
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20.22 Sagittal transabdominal ultrasonographic image of the ventral lumbar vertebral bodies of a 2-month-old Border Collie with discospondylitis. Note the ventrally bulging hypoechoic infected disc region between L3 and L4 (*). The black arrows indicate through transmission of sound at the intervertebral disc spaces. The white arrows show the incompletely mineralized physeal areas.
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